Abstract:
Background: Hepatitis B virus (HBV) infection is a particular concern in human immunodeficiency virus (HIV)
infected individuals. In Ethiopia, detailed clinical and virological descriptions of HBV prevailing during HIV co-infection
and symptomatic liver disease patients are lacking. The aim of this study was to investigate HBV virological characteristics from Ethiopian HBV/HIV co-infected and HBV mono-infected individuals.
Methods: A total of 4105 sera from HIV positive individuals, liver disease patients, and blood donors were screened
serologically for HBV. The overlapping polymerase/surface genome region of HBV from 180 infected individuals was
extracted, amplified, and sequenced for genotypic analysis.
Results: The HBsAg seroprevalence was detected 43% in liver disease patients, 8.4% in blood donors, and 6.7% in
HIV/HBV co-infected individuals. The occult HBV prevalence was 3.7% in HIV/HBV co-infected individuals and 2.8%
in blood donors with an overall prevalence rate of 3.4%. A phylogenetic analysis showed three HBV genotypes; A
(61.1%), D (38.3%) and E (0.6%). Genotype A belongs to subtypes A1 (99.1%) and A9 (0.9%), but genotype D showed
heterogeneous subtypes; D2 (63.8%) followed by D4 (21.7%), D1 (8.7%), D3 (4.3%), and D10 (1.4%).
Conclusions: The HIV/HBV co-infected individuals and blood donors showed lower HBsAg seroprevalence compared to liver diseases patients. Occult HBV prevalence showed no difference between HIV/HBV co-infected and
blood donor groups. This study demonstrated predominance distribution of HBV subtypes A1 and D2 in northwest
Ethiopia. The observed virological characteristics could contribute for evidence-based management of viral hepatitis
in Ethiopia where antiretroviral therapy guidelines do not cater for viral hepatitis screening during HIV co-infection.
Keywords: HBV, Genetic diversity, HIV/HBV co-infection, Ethiopia
